Why hybrid care starts with the patient

A combo of in-person and virtual visits is here to stay.

The emergence of COVID-19 forced telehealth to become a necessity. With stay-at-home orders and cancelations of nonessential appointments, virtual visits were often the only option for connecting with one’s medical team. In fact, McKinsey & Company reported that some providers saw 50 to 175 times the number of patients via telehealth than they did prior to the pandemic. Of note, Forrester estimates that patients logged more than 1 billion virtual care visits in 2020.Many envisioned that this was the beginning of the telehealth era and that phone and video appointments would continue to flourish post-pandemic. Although there is some truth to that statement, it’s important for health systems to be thoughtful of which services and patients are best suited for virtual care versus in person now that the immediate crisis is in our rearview. Hybrid care, which is a combination of in-person and virtual visits, is here to stay. Practices and health systems should be well equipped to offer a hybrid care model to patients and should consider the following elements when it comes to establishing a successful strategy.

The premise of hybrid care

Virtual visits will never completely replace in-person care because things like procedures, labs, imaging, immunizations, and certain medical visits such as broken bones or a wound infection can't be handled virtually. However, some patients will continue to opt for virtual visits, when appropriate, and have appreciated the added convenience of telehealth. To meet patients' expectations with both in-person and virtual visits, health systems should promote hybrid care to patients and make recommendations on the type of visit best suited for each patient. Physical care joins digital care to create a cohesive experience for both patients and providers. This type of approach ensures that physicians can adequately treat necessary medical conditions in person but still allows patients to schedule a virtual visit when warranted.

When a virtual visit makes sense

Although popular, telehealth isn't a one-size-fits-all solution. For telehealth visits to remain productive and valuable, providers need to focus on appointments that can be successfully resolved virtually. Otherwise, they risk alienating patients who may view virtual care as an unnecessary and costly step when their telehealth appointment results in a required follow-up office visit. However, telehealth follow-ups offer a convenient and efficient channel to deliver post-visit and post-operative care, particularly helpful to patients in situations where, for example, transportation may be an issue. Including remote low-tech patient monitoring, such as patient-reported glucose or blood pressure readings, can make the visit more impactful and now even some cell phones and smart watches have the tech capabilities to make monitoring even easier for patients.

For aging and non-English speaking populations, consider how technology may help or hinder patient visits. As the provider, it’s important to consider the following questions prior to an upcoming visit to understand if the intended venue of care is correct.

  • Does the patient understand how to access care virtually?
  • How will it be determined if a virtual visit is by telephone or video, and who will communicate that to the patient?
  • As the provider within a practice or health system, do you allow extended family members to attend virtual visits?
  • If a patient can be seen virtually, would it provide an added benefit for an adult/English speaker to attend the visit?
  • What privacy or safety concerns come in to play?
  • Will a medical translator be available to join a telephone or video visit if needed?
  • Is it possible for a family member to join from a different remote location?

The answers to the questions will help determine which care option is best suited for the patient, whether a virtual visit would be successful or if an in-person appointment is the best choice.

The importance of considering all patient populations

The COVID-19 pandemic has shaped healthcare in many ways, and has also helped to prepare us for future crises. In that vein, it’s important to consider hybrid care as a rule—not just an exception. This means that the needs and expectations of all patient populations must be considered.

For example, the use of remote monitoring for chronic conditions is on the rise, especially for the elderly population. Some insurance programs and the like are issuing health trackers to promote the benefits of staying active, as well as encouraging the use of cell phones and smart watches to help track activity. It’s crucial for practices and health systems to understand how these technologies will impact care delivery and virtual visits.

Underserved and rural populations should be prioritized as well. The digital divide may heighten as complimentary high-speed access is removed from specially funded virtual education hotspots. Providers should consider if their patients have the necessary access and/or reliable technology to attend virtual visits successfully. Of note, patients residing in rural or remote areas with strong internet access may become accustomed to virtual options. They may feel relieved to avoid potentially long wait times at the doctor’s office and may want to see their provider virtually to save travel time and gas money. Regardless of location, does more convenience equate to a different level of care? It’s important to strike a balance all around.

How health systems should ensure hybrid care is seamless for patients

Providing support ahead of one’s scheduled virtual appointment is key. Prior to a telehealth visit, a practice or health system should send a test URL 48 to 72 hours in advance, giving the patient the opportunity for a test run. This will help identify potential technology issues that could arise during the appointment and to make sure there is device compatibility. Offering timely support for patients who run into problems when conducting their tests is crucial. Although online instructions and videos can be helpful for some, others would prefer live voice via a provided phone number or online support to fix their appointment setup challenges.

Hospitals and health systems should also confirm that their telehealth platforms and support centers are multilingual. Being able to serve English and Spanish-speaking patients is an excellent start, but a full range of multilingual support including online help videos and phone support should be available for patients with language barriers.

Success in a hybrid care world will come with directing patients to the right venue of care. It starts with effectively engaging with patients in the right channel, at the right time, with a message that resonates. In a post-pandemic world, implementing a hybrid care model is the best way to ensure patients have a seamless experience both virtually and in person.

Matt Dickson is Senior Vice President of Stericycle Communication Solutions. He is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the healthcare industry for nearly 25 years. Find him on LinkedIn.